Provider Demographics
NPI:1033114905
Name:AIZENMAN, DAVID BURTON (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BURTON
Last Name:AIZENMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3209
Mailing Address - Country:US
Mailing Address - Phone:205-664-9990
Mailing Address - Fax:205-664-8882
Practice Address - Street 1:775 2ND ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3209
Practice Address - Country:US
Practice Address - Phone:205-664-9990
Practice Address - Fax:205-664-8882
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51509883OtherBCBS
E90838Medicare UPIN